Maine Drug Abuse

All of New England has been hard hit by the addiction and overdose epidemic that has been sweeping the nation. With some of the highest rates of drug use, addiction, and overdose in the country, families across the region are in crisis and looking for a way out.

Maine has not been left out of this epidemic. In fact, some of the highest rates of addiction and overdose have occurred in this New England state, with deaths driven primarily driven by opiate drugs, according to Business Insider – from prescription painkillers like OxyContin to heroin to synthetic opiates like fentanyl – there is a great deal of work that needs to be done in order to effect positive change and help individuals and their families to heal from the effects of addiction and drug use.

Addiction is widely understood as a medical disorder, one that requires medical treatment for healing. Government officials have recognized this fact and are working to implement legislative changes that would fund more treatment programs, improve access to those treatment services, decrease stigma, increase understanding of addiction and the healing process, and help to prevent future cases. The Obama administration pledged more than $10 billion in federal funds to support drug education programs and increased treatment services, and many states across the country and especially in New England are working to make similar changes.

Reported abuse of or addiction to illicit drugs in the past year remained about the same, rising slightly from 2.61 percent to 2.62 percent. Rates of past-year addiction remained the same as well at 1.87 percent both years.

The NSDUH study also noted that about 7.67 percent of Mainers required treatment for alcohol or drug use or addiction and that most of that number did not connect with the professional treatment needed to heal.

Drug Overdose Deaths in Maine

In March 2016, the University of Maine released a memo to Maine Attorney General Janet T. Mills detailing the latest information on the drug overdose deaths across the state. Findings include the following:

In 2015, 272 people in Maine died due to use of drugs, a total that is 31 percent higher than in 2014.

Use of heroin and synthetic fentanyl (non-pharmaceutical) were largely to blame for the increase and often used in combination with one another by overdose victims. The second half of 2015 saw 20 percent more deaths caused by fentanyl than the first half as well as 5 percent more deaths caused by heroin used.

In 2015, 107 deaths, or 39 percent of all overdoses, were caused by heroin use, and 87 deaths, or 32 percent of all overdoses, were caused by fentanyl. These two drugs were responsible for 58 percent of all drug overdoses that year.

Additionally, 111 of the drug overdose deaths in Maine in 2015 were contributed to or caused by use of prescription painkillers, often in combination with use of other substances, an estimated 41 percent of drug overdose deaths.

Men were significantly more likely to be victims of overdose death: 67 percent of overdose victims were male.

The average age of death for overdose victims in Maine in 2015 was 42.

Numbers of deaths were relatively even across all age groups, with highest percentages occurring in the 25-29, 30-34, and 35-39 age groups.

Maine Attorney General Janet Mills responded in a memo released from her office: “These death statistics are just one measure of Maine’s drug crisis. More must be done to preserve lives and protect our communities from the negative effects that drug abuse has on us. Prevention, intervention, treatment and law enforcement all must play larger roles in stemming this deadly tide.”

County by County, Town by Town

The University of Maine memo from 2016 on data from 2015 also took note of the geographic distribution of deaths caused by overdose across the state of Maine. They found that:

Every county in Maine lost at least one person to drug overdose.

Five counties had 10 or more overdose deaths in 2015, including:

Cumberland with 86 deaths (32 percent of state overdoses)

York with 38 deaths (14 percent of state total)

Kennebec with 33 deaths (12 percent of Maine total overdoses)

Androscoggin with 27 deaths (10 percent of Maine overdoses)

Penobscot with 26 deaths (10 percent of all state overdoses)

Portland, Maine, had the highest rates of drug overdose in 2015, with 46 deaths or 17 percent of all overdoses in the state.

Bangor, Maine, and Lewiston, Maine, also experienced high rates of drug overdose, 13 deaths and 15 deaths respectively, or 5 percent and 6 percent of all overdoses in the state.

Why Is Maine in Crisis?

There is no one single cause of the rampant drug problem in Maine or any other state in New England. As is often the case with even individual users of drugs and alcohol, there are a number of contributing factors that add up to an increased likelihood of the development of a substance use disorder. Some of the factors that may be contributing to the current drug crisis in Maine may include any or all of the following:

Perception of Harm

As compared to the rest of the country, Mainers tend to have a low perception of harm when it comes to use of alcohol and marijuana. That is, many Mainers do not perceive that there is great risk of harm associated with regular use of marijuana or binge drinking (e.g., drinking four or more drinks for women or five or more drinks for men, according to the Substance Abuse and Mental Health Services Administration, also known as SAMHSA).

Specifically, the NSDUH from 2014 found a decrease in the perception of harm related to marijuana use, as it dropped from 20.02 percent to 19.01 percent.

Drug Trafficking

The US Department of Justice has highlighted the entire New England area, including Maine, as a High-Intensity Drug Trafficking Area. This means that a great deal of drug trafficking comes through the state on its way from one big city to another where drug use has historically been more prevalent.

Specifically, cocaine, marijuana, heroin, and black market prescription painkillers have all been spotlighted as substances that are heavily trafficked across Maine, making these substances easily accessible to residents.

Additionally, the 2015 National Drug Threat Survey found that the Northeast, including Maine, has the highest rates of crime related to heroin in the country, as well as high rates of marijuana-related crimes and crimes related to the nonmedical use of painkillers.

Suicidal thoughts and tendencies, depression, and other mental illnesses can contribute to cravings for drugs and alcohol, as many seek to “self-medicate” symptoms rather than reach out for help.

Climate

According to US Climate Data, temperatures lows can get down into the teens in winter, with temperatures cooling considerably as early as October and not warming up again until May. A long winter with short, dark days may exacerbate issues with substance use and abuse, causing many to turn to drugs and alcohol as a way to manage boredom or depression that can occur during the winter months in northern locations.

Political Issues

Common use of marijuana as well as a low perception of harm related to use of drugs and alcohol can contribute to the idea that use of any drugs may not be as dangerous as previously thought. Unfortunately, this misconception can contribute to earlier use of substances as well as higher-dose use and more frequent binge episodes, all of which may serve as a foundation for the development of a substance use disorder, including addiction.

Additionally, Governor Paul LePage has strong views about how drug use, abuse, and addiction should be approached and how state financial resources should be allocated in terms of addressing the problem – views that do not prioritize treatment of acute overdose or chronic addiction disorders.

A State Apart

Governors from five states in New England met in mid-2014 to come up with a plan that would help them all work together to manage the problem of addiction in the region, as reported by The New York Times. In the months following, Governor LePage took part in a panel to discuss opiate addiction prevention methods and how states could share information across state lines to better support all New England residents, according to Central Maine.

Unfortunately, efforts to connect Mainers with treatment may be stymied by the governor’s stance on a number of key proposals that would have a positive impact on rates of drug overdose in the state. He was one of seven governors who refused to sign a national pact committed to fighting opioid treatment, as reported by the Portland Press Herald, because it was too light on law enforcement and too focused on providing treatment; it also included a focus on increasing the use of naloxone. At different times, he has proposed calling in the Maine National Guard to address the problem of drug addiction in the state if he was not given the funds he requested to hire more Maine Drug Enforcement Agency (MDEA) agents, judges, and state prosecutors, according to the Portland Press Herald.

Governor LePage’s opposition to the widespread implementation of use of the drug naloxone, a medication that can reverse an opiate overdose and stop it from being fatal if administered in time, is particularly problematic for Maine families who are facing opiate addiction. When speaking on the George Hale and Ric Tyler Show, Governor LePage famously said about the use of naloxone: “I’m a believer that you work with somebody, you give a hand-up, you give it one time. I know they’ll relapse. You can count on somebody relapsing. You do it a second time, but once you get to the third time, there comes a point is when is enough, enough?”

This cold, hard attitude is part of what drives the stigma against those struggling with addiction, a reason that many cannot or will not admit they need help until it is too late. Maine families living with addiction understand that it is a medical disorder that requires medical treatment, not a criminal act that requires incarceration and other forms of punishment. For many, the best recourse is going out of state for treatment, finding a program that offers the ongoing treatment and support needed to overcome the disease of addiction.

Maine’s Plan for Healing

Currently, Maine has in place a number of different campaigns and treatment programs dedicated to increasing education of Mainers and helping them to avoid the development of addiction and/or connect with treatment in cases where it is needed.

Though there are a number of drug addiction treatment programs across the state of Maine, many residents find that there are long waiting lists to get in or that they are otherwise ineligible for treatment due to income or other factors. In order to connect with effective treatment in a timely manner, many Maine residents are choosing to leave the state and enroll in drug rehab programs that are out of state. This option can provide a number of benefits for individuals struggling with addiction and their families, including:

Shift in perspective: The act of getting on a plane or driving a long distance to go to treatment can help to facilitate a mental shift that can be beneficial to recovery.

Healing environment: A new environment can be a healing environment. A change in scenery can contribute to the ability to focus on the work of recovery.

New faces: Meeting new people in a treatment program that is far from home can increase one’s comfort with the confidentiality of treatment.

Distance from stressors at home: At home, it can be difficult to focus on recovery when one is continually faced with bills, relationship issues, and other stressors that may have contributed to active drug use and addiction.

An out-of-town addiction treatment program can provide a much-needed break.

Plans for the Future

There are a number of propositions on the table that could help Mainers continue on a positive track toward healing through treatment, education, and prevention. For example, many are hoping that Governor LePage will begin to work more closely with governors of other states in New England who are working to ensure that all in need connect with appropriate treatment services.

Another such proposition is one that comes out of the Office of the Maine Attorney General, a call for a change to the federal rule that excludes methadone clinics from reporting data about prescription and use practices to state Prescription Drug Monitoring Programs (PDMPs). PDMPs are extremely effective in helping to identify those who are abusing the medical system with the goal of getting multiple prescriptions for similarly addictive medications, either with the goal of personal use or selling the pills. Because methadone is an opiate drug, some may abuse this system as well by making use of methadone treatment services and then getting opiate pills from doctors on the side. Including methadone clinics in data monitored by the PDMPs would help to identify people who are still struggling with addictive use of opiates despite the attempt to get clean and sober.

The Office of the Maine Attorney General also called for the adoption of the new recommended guidelines for the prescription of addictive painkillers put out by the Centers for Disease Control (CDC) in 2016. These guidelines recommend using addictive painkillers only as a last resort, first making use of non-medication resources, such as physical therapy and other holistic treatment options, then choosing low-dose painkiller use if absolutely necessary and only increasing doses after long-term attempts at use of other methods of pain management.

More Resources

Other resources for information, support, and referrals for Maine families struggling with addiction include:

“Dose of Reality” Campaign: Launched in July 2016 by the Office of the Maine Attorney General, this campaign seeks to educate Mainers about the use and abuse of prescription painkillers through a new website and three public service announcements.

Maine Association of Substance Abuse Programs: This group is a nonprofit membership organization that represents the many different types of treatment programs available across the state. It can provide information to families in need.

Community Epidemiology Surveillance Network (CESN): CESN provides ongoing and updated information about the latest patterns and trends noticed in Mainers struggling with substance use as well as co-occurring mental health disorders.